Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Randy W Clark

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1134086986

Randy W Clark is an Addiction (Substance Use Disorder) Counselor in Summerfield, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2026

Practice location Address checks out

14911 SE 73rd Ave
Summerfield, FL 34491-4225
Phone: (352) 789-2908
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CAP.0100612 (FL)

Record details

NPI number1134086986
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 5, 2026
Last updated in NPPESFebruary 23, 2026
Certification dateFebruary 23, 2026
Mailing address14911 Se 73rd Ave, Summerfield, FL 34491-4225

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